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• W1993666712 abstract "<i>Background:</i> Standard practice has been to delay carotid endarterectomy (CEA) for 2 months following acute stroke to avoid a perceived risk of cerebral haemorrhage. We investigated whether early CEA reduces early recurrent stroke and improves outcome in partial anterior circulation infarction (PACI). <i>Methods:</i> Patients with PACI and a Barthel score of >18 before stroke underwent carotid duplex and CT imaging within 7 days of stroke. Forty consenting patients fit for surgery with greater than 70% ipsilateral carotid stenosis were randomised, 19 to ‘early’ (within 24 h) and 21 to ‘delayed’ surgery (at 8 weeks). Modified Rankin and Barthel scores were recorded at 1 week, 2 months, 6 and 12 months. <i>Results:</i> Rankin scores improved more rapidly following ‘early’ surgery to a score of 1 (0–4) at 2 and 6 months compared with 2.5 and 2 (1–4), respectively, for delayed surgery (p < 0.05). Barthel scores were also significantly improved following ‘early’ CEA at 7 days but both groups reached a median score of 20 by 2 months. Four ‘delayed’ and 3 ‘early’ patients suffered extension or recurrence of neurological deficits with 1 death in each group. <i>Conclusions:</i> Early CEA within 7 days of ischaemic stroke improved functional outcome with earlier hospital discharge. A large multicentre study is needed to exclude the possibility that ‘early’ CEA increases the risk of cerebral haemorrhage or death." @default.
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• W1993666712 date "2004-01-01" @default.
• W1993666712 modified "2023-09-29" @default.
• W1993666712 title "Early Carotid Surgery in Acute Stroke: A Multicentre Randomised Pilot Study" @default.
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• W1993666712 doi "https://doi.org/10.1159/000079942" @default.
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